快速流式细胞术分类计数外周血白细胞生物参考区间的建立及验证  

Reference intervals and its verification for leukocyte differential count in peripheral blood by CytoDiff flow cytometry

作　　者：屈晨雪[1] 普程伟[1] 尚柯[1] 董宁[1] 邢莹[1] 李秀锋[1] 王建中[1] 

机构地区：[1]北京大学第一医院检验科,100034

出　　处：《中华医学杂志》2015年第26期2079-2083,共5页National Medical Journal of China

摘　　要：目的 建立快速流式细胞术分类计数外周血白细胞的生物参考区间并进行验证.方法 选取北京大学第一医院健康体检者278名、触发血液分析仪复检规则患者550例以及未触发复检规则患者102例为研究对象.采集外周静脉血,运用血细胞分析仪、快速流式细胞术和形态学检查法分别进行白细胞分类计数.比较健康成年人各年龄组、不同性别组各类白细胞的差异,建立生物参考区间并验证.统计分析血细胞分析仪、快速流式细胞术和形态学分类计数外周血白细胞的相关性,比较健康人和不同疾病组淋巴细胞亚群的差异.以形态学检查法为标准,利用ROC曲线评价快速流式细胞术分类计数原始细胞的实验诊断效率.结果 快速流式细胞术分类计数外周血16种白细胞,包括百分比和绝对计数,共32项参数,其中18项在男女性别之间差异有统计学意义（P＜0.05）,其余14项差异无统计学意义（P＞0.05）;除促炎性单核细胞百分比在各年龄组之间差异具有统计学意义外（P＜0.05）,其余各类白细胞在不同年龄间差异均无统计学意义（均P＞0.05）.在健康人和临床样本中,快速流式细胞术与血细胞分析仪、形态学检查法分类计数5种成熟白细胞,均具有一定相关性（P＜0.05）.通过ROC曲线分析,T＋NK与B淋巴细胞比值的临界值为1.0时,诊断慢性淋巴细胞白血病（CLL）的敏感度为90.9％,特异度为99.8％.以形态学检查法为标准,快速流式细胞术分类计数原始细胞临界值为＞1％时,敏感度为100％,特异度为96.1％,准确度为96.2％.结论 建立了北京地区成年人快速流式细胞术分类计数外周血白细胞的生物参考区间.快速流式细胞术比常规白细胞分类计数可提供更多的外周血白细胞亚群,特别是对诊断CLL和急性白血病具有较高的实验诊断效率.Objective To establish and verify the reference intervals for leukocyte differential count in peripheral blood by CytoDiff flow cytometry.Methods Leukocyte differentiation count was analyzed by using hematology analyzer,CytoDiff flow cytometry and morphology differential count in 278 healthy controls,550 flagged and 102 unflagged samples.The reference intervals of leukocyte parameters were established and verified according to the healthy controls.Then the correlations of five leukocytes were analyzed among hematology analyzer,CytoDiff flow cytometry and morphology differential count.Lymphocyte subsets were analyzed and compared between healthy controls and patients with different diseases.The CytoDiff flow cytometric blast counts were explored to analyze the clinical diagnostic efficiency compared to morphology differential count as a reference method.Results CytoDiff flow cytometry can differentiate the leukocyte into 16 parameters,including percentage and absolute count,therefore 32 parameters in total.Among these parameters,18 parameters had significant difference between male and female （P 〈 0.05）,and the others had no difference （P 〉0.05）.Except the CD16POS monocyte,there were no difference among ages in other parameters.The correlation between hematology analyzer,CytoDiff flow cytometry and morphology differential count were good for neutrophils,lymphocytes,monocytes,basophils and eosinophils in healthy controls and clinical samples.When the cutoff value of the ratio of T ＋ NK and B lymphocyte was set at 1.0 by ROC,the sensitivity was 90.9% and specificity was 99.8% for diagnosing the chronic lymphocyte leukemia （CLL）.When the cutoff value of blast count by CytoDiff flow cytometry was set at 1%,the sensitivity was 100%,specificity was 96.1% and accuracy was 96.2% by morphology differential blast count for the reference method.Conclusions Establish and verify the reference interval of leukocyte differential count in peripheral blood by CytoDiff flow cytometry in the adults of Beijing regio

关 键 词：参考区间 白细胞分类计数 流式细胞术 血细胞形态学 

分 类 号：R446.1[医药卫生—诊断学]